11D0266658 CLIA NUMBER - GLENN E FUSSELL MD

Laboratory Demographics

  • CLIA Code: 11D0266658
  • Facility Name: GLENN E FUSSELL MD
  • Facility Address: 2827 WARM SPRINGS RD SUITE 3-B
    COLUMBUS, GA
    ZIP 31904
  • Facility Phone: 706 324-4177
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: GLENN E. FUSSELL MD
  • NPI Number: 1861509184
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 11D0266658
LAB Type Physician Office
Facility Name GLENN E FUSSELL MD
Street 2827 WARM SPRINGS RD SUITE 3-B
City COLUMBUS
State GA
ZIP 31904
Phone 706 324-4177
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/10/2024
Certificate Expiration Date 8/9/2026
Facility Type Physician Office
Lab Director GLENN E. FUSSELL MD

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This page was last updated on: 9/29/2025